Upper Gastrointestinal Bleeding : Diagnostic Studies

Diagnostic Studies

• Endoscopy
  • Primary tool for diagnosing source of upper GI bleeding
  • Before performing
    • Lavage may be needed for clearer view
      • NG or orogastric tube placed, and room-temperature water or saline used
      • Do not advance tube against resistance
  • Stomach contents aspirated through a large-bore (Ewald) tube to remove clots
• Angiography
  • Used to diagnose only when endoscopy cannot be done
  • Invasive procedure
    • May not be appropriate for high-risk or unstable patient
  • Catheter placed into left gastric or superior mesenteric artery until site of bleeding is discovered
• Laboratory studies
  • Complete blood cell count (CBC)
  • Blood urea nitrogen (BUN)
  • Serum electrolytes
  • Prothrombin time, partial thromboplastin time
  • Liver enzyme measurements
• Laboratory tests
  • ABG measurements
  • Typing/cross matching for possible blood transfusions
  • Test vomitus/ stools for presence of gross and occult blood